First, it's important to carefully consider the source of information and then to discuss the information you find with your health care professional. These questions and answers can help you determine whether the health information you find on the Internet or receive by e-mail from a Web site is likely to be reliable. The medicines that sold online can be fake (counterfeit or 'copycat' medicines); can be too strong or too weak, or have dangerous ingredients, or have expired (are out-of-date), or haven't been approved or checked for safety and effectiveness, can be made using non-safe standards, or not safe to use with other medicine or products you use. You have to talk with your doctor and have a physical exam before you get any new medicine for the first time. Use only medicine that has been prescribed by your doctor or another trusted professional. Make sure the site requires a prescription and has a pharmacist available for questions.
Although medicines can make you feel better and help you get well, it's important to know that all medicines, both prescription and over-the-counter, have risks as well as benefits. Before using any medicine--as with many things that you do every day--you should think through the benefits and the risks in order to make the best choice for you. To obtain the benefits of riding in a car, you think through the risks. You consider the condition of your car and the road, for instance, before deciding to make that trip to the store. The same is true before using any medicine. Every choice to take a medicine involves thinking through the helpful effects as well as the possible unwanted effects. The benefit and risk decision is sometimes difficult to make. The best choice depends on your particular situation. You must decide what risks you can and will accept in order to get the benefits you want. Important: think it through and work together with your doctor, pharmacist, or other health care professional to better manage the benefits and risks of your medicines. Important things is tell to your doctor about any allergies or sensitivities that you may have. Tell about anything that could affect your ability to take medicines, such as difficulty swallowing or remembering to take them. You have to always tell your doctor if you are or might become pregnant, or if you are nursing a baby. Always ask questions about any concerns or thoughts that you may have. Read and follow the directions on the label and the directions from your doctor, pharmacist, or other health care professional. If you stop the medicine or want to use the medicine differently than directed, consult with your health care professional. You always have to pay attention to how you are feeling; note any changes. Write down the changes so that you can remember to tell your doctor, pharmacist, or other health care professional.
There are more opportunities today than ever before to learn about your health and to take better care of yourself. It is also more important than ever to know about the medicines you take. Early in a drug's development, companies conduct research to detect or predict potential interactions between drugs. Experts evaluate the drug-interaction studies as part of assessing a drug's safety. When a drug is taken orally, it usually travels from the stomach to the liver, where it can be metabolized-the process of breaking down and removing chemicals from the body. Enzymes are complex proteins that act as catalysts in starting or speeding up chemical reactions. They cause a specific chemical change in other substances without being changed themselves. A drug may affect these enzymes by inhibiting them, which causes reduced activity of the enzyme and a buildup of the drug in the body. Or drugs may "induce" the enzymes, which causes increased activity of the enzyme and a reduction of the drug in the body. This phase of research in test tubes, known as in vitro studies, allows researchers to perform drug-interaction studies in labs by testing a drug with other drugs that have the same route. This has made the research faster and more accurate. If two drugs go through the same enzyme, the presence of one drug can prevent the metabolism of the other. So this allows you to look at the worst-case scenarios and ask: 'What if we put this drug with that one, knowing that they have the same route?'" In addition to having a good grasp of drugs and their effects, doctors take medication histories, and they consult with other members of their team to guide them in making decisions about drug interactions. They also use concise drug summaries and resources on pharmacological principles. So rather than asking patients what medications they take, doctors should make the questions specific: "Are you taking any over-the-counter medication? Are you taking any herbal treatments or vitamins?" Some antibiotics, such as rifampin, can lower the effectiveness of birth control pills. Sildenafil, the active ingredient in the erectile dysfunction drug Viagra, should not be taken with nitrates for heart treatment because of the potential for dangerously low blood pressure. Drug interactions with dietary supplements includes herbs and vitamins, which can interact with drug-metabolizing enzymes. St. John's wort is an herb commonly used by people with cancer to improve mood, but research has shown it interferes with the metabolism of irinotecan, a standard chemotherapy treatment. Vitamin K (in dietary supplements or food) produces blood-clotting substances that may reduce the effectiveness of blood-thinning medicines like warfarin. Examples of food with tyramine are cheese and soy sauce. Grapefruit juice should not be taken with certain blood pressure-lowering drugs or cyclosporine for the prevention of organ transplant rejection. Alcohol should not be taken with pain relievers such as Tylenol (acetaminophen) or ibuprofen because of the increased risk of liver damage or stomach bleeding.
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